[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[S. 1496 Introduced in Senate (IS)]







108th CONGRESS
  1st Session
                                S. 1496

  To provide for the expansion and coordination of activities of the 
 National Institutes of Health and the Centers for Disease Control and 
      Prevention with respect to research and programs on cancer 
                 survivorship, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                July 30 (legislative day, July 21), 2003

   Mrs. Hutchison (for herself, Mr. Kennedy, Mrs. Feinstein, and Mr. 
    Harkin) introduced the following bill; which was read twice and 
  referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
  To provide for the expansion and coordination of activities of the 
 National Institutes of Health and the Centers for Disease Control and 
      Prevention with respect to research and programs on cancer 
                 survivorship, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Cancer Survivorship Research and 
Quality of Life Act of 2003''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) There are more than 9,600,000 individuals in the United 
        States today who are cancer survivors (living with, through, 
        and beyond cancer).
            (2) 61 percent of cancer survivors are 65 years of age and 
        older.
            (3) 62 percent of adults diagnosed with cancer today will 
        be alive 5 years from now.
            (4) In 1960, 4 percent of children with cancer survived 
        more than 5 years.
            (5) 77 percent of children (age 0 through 14) diagnosed 
        with cancer today will be living five years from now.
            (6) Three out of every four American families will have at 
        least one family member diagnosed with cancer.
            (7) 24 percent of adults with cancer are parents who have a 
        child 18 years or younger living in the home.
            (8) One of every four deaths in the United States is from 
        cancer. In 2002, 556,500 Americans will die of cancer--more 
        than 1,500 people a day.
            (9) The annual cost of cancer in the United States is 
        $180,000,000,000 in direct and indirect costs.
            (10) In fiscal year 2001 the National Institutes of Health 
        invested $38,000,000 in survivorship--less than $4.25 per 
        survivor.

SEC. 3. CANCER CONTROL PROGRAMS.

    Section 412 of the Public Health Service Act (42 U.S.C. 285a-1) is 
amended--
            (1) in the first sentence, by inserting ``, for 
        survivorship,'' after ``treatment of cancer'';
            (2) in paragraph (1)(B), by striking ``cancer patients'' 
        and all that follows and inserting the following: ``cancer 
        patients, families of cancer patients, and cancer survivors, 
        and''; and
            (3) in paragraph (3), by inserting ``and concerning cancer 
        survivorship programs,'' after ``control of cancer''.

SEC. 4. EXPANSION AND COORDINATION OF ACTIVITIES OF NATIONAL INSTITUTES 
              OF HEALTH WITH RESPECT TO CANCER SURVIVORSHIP RESEARCH.

    (a) In General.--
            (1) Technical amendment.--Section 3 of Public Law 107-172 
        (116 Stat. 541) is amended by striking ``section 419C'' and 
        inserting ``section 417C''.
            (2) New section.--Subpart 1 of part C of title IV of the 
        Public Health Service Act (42 U.S.C. 285 et seq.), as amended 
        pursuant to paragraph (1) of this subsection, is amended by 
        adding at the end the following:

``SEC. 417E. EXPANSION AND COORDINATION OF ACTIVITIES WITH RESPECT TO 
              CANCER SURVIVORSHIP RESEARCH.

    ``(a) In General.--
            ``(1) Expansion of activities.--The Director of NIH shall 
        expand and coordinate the activities of the National Institutes 
        of Health with respect to cancer survivorship research.
            ``(2) Administration of program; collaboration among 
        agencies.--The Director of NIH shall carry out this section 
        acting through the Director of the National Cancer Institute 
        and in collaboration with any other agencies that the Director 
        determines appropriate.
    ``(b) Office on Survivorship.--
            ``(1) In general.--The Director of NIH shall establish an 
        Office on Cancer Survivorship within the National Cancer 
        Institute through which the activities under subsection (a)(1) 
        shall be implemented and directed.
            ``(2) Associate director for cancer survivorship; 
        appointment; function.--There shall be in the National Cancer 
        Institute an Associate Director for Cancer Survivorship to 
        coordinate and promote the programs in the Institute concerning 
        cancer survivorship research. The Associate Director shall be 
        appointed by the Director of the Institute from among 
        individuals who, because of their professional training or 
        experience, are equipped to address the breadth of needs 
        associated with cancer survivorship.''.
    (b) Funding.--Section 417B of the Public Health Service Act (42 
U.S.C. 285a-8) is amended by adding at the end the following:
    ``(e) Office on Cancer Survivorship.--Of the amounts appropriated 
for the National Cancer Institute for a fiscal year, the Director of 
the Institute shall reserve an amount for the Office of Cancer 
Survivorship under section 417E(b)(1).''.

SEC. 5. EXPANSION OF CDC COMPREHENSIVE CANCER PROGRAMS; PROGRAMS TO 
              IMPROVE CANCER SURVIVORSHIP.

    (a) In General.--The Secretary of Health and Human Services 
(referred to in this section as the ``Secretary''), acting through the 
Director of the Centers for Disease Control and Prevention, shall--
            (1) expand and update the National Comprehensive Cancer 
        Control Program;
            (2) assist States, territories, tribal organizations, and 
        the District of Columbia in developing and implementing a 
        cancer prevention and control program so that each entity will 
        have an active plan in place and so that States, territories, 
        tribal organizations, and the District of Columbia will conduct 
        activities to prevent and control cancer and so that 
        disparities in specific populations will be addressed;
            (3) establish programs that demonstrate how to prevent and 
        control cancer and improve access to and the quality of cancer 
        care among racial and ethnic minority and medically underserved 
        populations with disproportionate incidence of or death from 
        cancer;
            (4) promote cancer education, prevention, and early 
        detection of cancer; and
            (5) award grants to public and nonprofit organizations for 
        cancer control and prevention.
    (b) Certain Studies and Programs.--
            (1) In general.--The Secretary, acting through the Director 
        of the Centers for Disease Control and Prevention and in 
        collaboration with the Director of the Office of Cancer 
        Survivorship within the National Cancer Institute, shall study 
        the unique health challenges associated with cancer 
        survivorship and carry out projects and interventions to 
        improve the long-term health status of cancer survivors. Such 
        projects shall be carried out directly and through the awards 
        of grants or contracts.
            (2) Certain activities.--Activities under paragraph (1) 
        include--
                    (A) the expansion, in collaboration with the 
                Surveillance, Epidemiology, and End Results Program 
                (SEER) at the National Cancer Institute and with the 
                Agency for Healthcare Research and Quality, of current 
                cancer surveillance systems to track the health status 
                of cancer survivors and determine whether cancer 
                survivors are at-risk for other chronic and disabling 
                conditions;
                    (B) assess the unique public health challenges 
                associated with cancer survivorship; and
                    (C) the development and implementation of a 
                national public health cancer survivorship action plan, 
                in partnership with health organizations focused on 
                cancer survivorship, to be carried out in coordination 
                with the State-based comprehensive cancer control 
                program of the Centers for Disease Control and 
                Prevention, in collaboration with the Office of Cancer 
                Survivorship at the National Cancer Institute, and in 
                consultation with other appropriate entities, to 
                support and advance cancer survivorship through--
                            (i) surveillance and research;
                            (ii) communication, education, and 
                        training;
                            (iii) program, policies, and 
                        infrastructure; and
                            (iv) access to quality care and services.
    (c) Coordination of Activities.--The Secretary shall assure that 
activities under this section are coordinated as appropriate with other 
agencies of the Public Health Service.
    (d) Report to Congress.--Not later than October 1, 2004, the 
Secretary shall submit to the Congress a report describing the results 
of the evaluation under subsection (a), and as applicable, the 
strategies developed under such subsection.
    (e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2004 through 2008.

SEC. 6. MONITORING AND EVALUATING QUALITY CANCER CARE AND CANCER 
              SURVIVORSHIP.

    (a) In General.--Part M of title III of the Public Health Service 
Act (42 U.S.C. 280e et seq.) is amended by inserting after section 399E 
the following:

``SEC. 399E-1. MONITORING AND EVALUATING QUALITY CANCER CARE AND CANCER 
              SURVIVORSHIP.

    ``(a) In General.--The Secretary shall make grants to eligible 
entities for the purpose of enabling such entities to monitor and 
evaluate quality cancer care, develop information concerning quality 
cancer care, and monitor cancer survivorship. The Secretary shall carry 
out this section jointly through the Director of the Centers for 
Disease Control and Prevention and the Director of the National Cancer 
Institute.
    ``(b) Eligible Entities.--For purposes of this section, an entity 
is an eligible entity for a fiscal year if the entity--
            ``(1) operates a statewide cancer registry with funds from 
        a grant made under section 399B for such fiscal year;
            ``(2) is certified by the North American Association of 
        Central Cancer Registries.
            ``(3) has personnel scientifically qualified to conduct 
        population-based epidemiology or analyze health services or 
        outcomes research; and
            ``(4) has access to a broad-based clinical research cohort 
        or an established clinical case base.
    ``(c) Contracting Authority.--In carrying out the purpose described 
in subsection (a), an eligible entity may expend a grant under such 
subsection to enter into contracts with academic institutions, cancer 
centers, and other entities, when determined appropriate by the 
Secretary.
    ``(d) Application for Grant.--A grant may be made under subsection 
(a) only if an application for the grant is submitted to the Secretary 
and the application is in such form, is made in such manner, and 
contains such agreements, assurances, and information as the Secretary 
determines to be necessary to carry out this section.
    ``(e) Authority of Secretary Regarding Use of Grant.--The Secretary 
shall determine the appropriate uses of grants under subsection (a) to 
achieve the purpose described in such subsection.
    ``(f) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated such sums as 
may be necessary for each of the fiscal years 2004 through 2008.''.
    (b) Conforming Amendment Regarding Authorization of 
Appropriations.--Section 399F(a) of the Public Health Service Act (42 
U.S.C. 280e-4(a)) is amended in the first sentence by striking ``this 
part,'' and inserting ``this part (other than section 399E-1),''.
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